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理解医学生向临床培训的过渡:一项关于变革性学习和职业身份形成的定性研究。

Understanding medical students' transition to clinical training: a qualitative study of transformative learning and professional identity formation.

作者信息

Ha Minh Thuy, Siddiqui Zarrin Seema

机构信息

College of Health Sciences, VinUniversity, Hanoi, Viet Nam

Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

BMJ Open. 2025 Jun 17;15(6):e098675. doi: 10.1136/bmjopen-2024-098675.

DOI:10.1136/bmjopen-2024-098675
PMID:40527562
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12182110/
Abstract

INTRODUCTION

The transition from preclinical to clinical training represents a pivotal stage in medical education, offering opportunities for transformative learning and professional identity formation. This study aims to explore how medical students reflect on their initial clinical learning experiences during the first week of clinical training, and how these reflections reveal early shifts in their professional identity, using Mezirow's transformational learning framework.

METHOD

A qualitative descriptive study was conducted at VinUniversity, Hanoi, Vietnam. 47 fourth-year medical students from a single cohort submitted reflective writings after their first week of clinical training. Thematic analysis was performed, with emergent themes mapped against the dominant phases of Mezirow's transformational learning framework.

RESULTS

Thematic analysis revealed four main themes: (1) disorientation and emotional adaptation, (2) bridging theory and practice, (3) learning from the clinical environment and (4) personal and professional growth. Reflections revealed both emotional and cognitive shifts, highlighting students' early adaptation and growth. Findings emphasised the need for enhanced mentorship, emotional resilience training and tailored bilingual communication strategies to optimise the transition.

CONCLUSIONS

Reflective writing captured students' first impressions of clinical training and highlighted the critical role of emotional adaptation, mentorship and experiential learning in supporting identity formation. These insights offer practical implications for enhancing student support strategies and curriculum design in medical education.

摘要

引言

从临床前培训到临床培训的过渡是医学教育中的一个关键阶段,为变革性学习和职业身份形成提供了机会。本研究旨在利用梅齐罗的变革性学习框架,探讨医学生在临床培训第一周如何反思他们最初的临床学习经历,以及这些反思如何揭示他们职业身份的早期转变。

方法

在越南河内的Vin大学进行了一项定性描述性研究。来自同一队列的47名四年级医学生在临床培训第一周后提交了反思性文章。进行了主题分析,并将新出现的主题与梅齐罗变革性学习框架的主要阶段进行了映射。

结果

主题分析揭示了四个主要主题:(1)迷失方向和情绪适应,(2)理论与实践的衔接,(3)从临床环境中学习,(4)个人和职业成长。反思揭示了情绪和认知上的转变,突出了学生的早期适应和成长。研究结果强调需要加强指导、情绪恢复力培训和量身定制的双语沟通策略,以优化过渡。

结论

反思性写作捕捉了学生对临床培训的第一印象,并强调了情绪适应、指导和体验式学习在支持身份形成方面的关键作用。这些见解为加强医学教育中的学生支持策略和课程设计提供了实际意义。

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